Use Cases
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Treatment/Care Coordination
Enables access to critical information to support improved care coordination for patients by their providers during transitions of care
Providers
Federal Agency
Encounter Alerts
Enables event notification of clinical encounters (with robust clinical details) to state & regional HIEs to populate longitudinal patient records
Providers
Payers
Task Based Exchange
Enables clinical data exchange that focuses on how to get data out of EHRs and into the hands of other people who need it – like patients, providers and public health.
Providers
Individuals
Federal Agency
Public Health
Clinical Data Exchange (CDex)
Enables clinical data exchange between providers and payers for: attachments for claims, prior authorization, documentation, quality programs and risk adjustment
Providers
Payers
Prior Authorization
Streamlines and automates prior authorization decisions and provides real-time determinations
Providers
Payers
Payer Data Exchange (PDex)
Enable Payer-to-Payer and Payer-to-Provider exchange for claims and encounter data
Providers
Payers
HEDIS Reporting
Supports submission of quality measures by health plans and payers to calculate measures based on their member population
Providers
Payers
Public Health Reporting
Enables providers to push discrete notifications (not full case reports), to public health agencies
Providers
Public Health
Electronic Case Reporting (eCR)
Enables providers’ EHRs to automatically notify public health agencies, via APHL, with rich clinical details, even when state and local reporting requirements vary
Providers
Public Health
Electronic Case Investigations
Provides the ability to query and retrieve additional information in response to a disease or condition that has already been reported under applicable law
Providers
Federal Agency
Public Health
Adverse Event Exchange
Enables providers to push adverse event notifications to public health entities, allowing them to query for additional information.
Providers
Federal Agency
Public Health
Electronic Lab Reporting (eLR)
Enables laboratories to automatically notify public health agencies with lab results (as required by applicable law)
*Seeking participant implementers
Providers
Public Health
Syndromic Surveillance Notifications
Allows for early detection and emerging health issues by monitoring non-specific indicators or patterns of symptoms that may indicate a public health threat.
*Seeking participant implementers
Federal Agency
Public Health
Prescription Drug Monitoring Program (PDMP)
Enabled exchange of PDMP with state repositories data via FHIR.
*Previously piloted, seeking participant implementers
Providers
Public Health
Immunization Notifications
Enables the push of immunization data for treatment purposes (not related to immunization registries)
*Seeking participant implementers
Providers
Public Health
Research
Enables National Institute of Health All of Us Research Program to fill in gaps in patient records received for research populations
Providers
Federal Agency
Social Security Disability Benefits Determination
Automates the request and retrieval of records to support applicants’ claims for disability benefits, accelerating the determination process.
Providers
Individuals
Federal Agency
Individual Access to Health Information
Enables individuals to retrieve their clinical data under TEFCATM
Providers
Individuals
Life Insurance Applications
Automates the request and retrieval of clinical records for life insurance applications
Providers
Individuals
Image Share
Enables organizations to share images.
*Seeking participant implementers
Providers
Payers
